Baseline Severity and Inflammation Would Influence the Effect of Simvastatin on Clinical Outcomes in Cirrhosis Patients

Statins in Chronic Liver Disease: Review of the Literature and Future Role

“…25 Patients with CTP A cirrhosis benefited the most from statin use with a median time to death of 14.4-years, more than twice that of the control group (p=0.005). 51,151 Statin use was also independently associated with a reduced risk of decompensation by 42% (HR=0.58, p=0.04). 151 However, Kronborg et al challenged these findings as atorvastatin use for 24-weeks to a maximum of 18-months did not improve overall mortality or prevent liver-related hospitalization (p=0.54 vs p=0.97 and p=0.61, respectively).…”

“…similar CTP distribution limitation. 51 Meanwhile, in two large trials by Vijayaraghavan et al and Pose et al, the majority of patients who required statin discontinuation due to severe elevation in AST and ALT were of CTP C. 52,53 The adverse events were only observed with 40mg daily of simvastatin and these patients also developed concomitant severe rhabdomyolysis and myopathy. 52,53 In a phase 2 trial comparing sorafenib, pravastatin and their combinations for the treatment of HCC in patients with CTP B cirrhosis, Blanc et al reported at least 5% or more patients in moderate-intensity pravastatin treatment arms experienced elevation in liver indexes.…”